Provider Demographics
NPI:1265728307
Name:FUSION CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:FUSION CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEPHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-707-3955
Mailing Address - Street 1:5388 DISCOVERY PARK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-8218
Mailing Address - Country:US
Mailing Address - Phone:757-707-3955
Mailing Address - Fax:757-603-6231
Practice Address - Street 1:201 BULIFANTS BLVD STE B
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5731
Practice Address - Country:US
Practice Address - Phone:757-603-6655
Practice Address - Fax:757-229-9741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty